STUDENT SKILLS CHECKLIST BOOKLET - Johnson College · Demonstrating competency in skills included...

Revised 4/18/2019

STUDENT SKILLS CHECKLIST BOOKLET

2019-2020

PHYSICAL THERAPIST ASSISTANT PROGRAM

2

Introduction

The patient is the focus of all health related professions, and health care providers must demonstrate

competency and safety during all patient interactions. PTA laboratory courses involve direct interaction

between students and faculty and provide an opportunity for students to learn and practice skills that will be

used in the clinic.

Each laboratory course includes a specific set of skills that have been identified as skills that an entry-level PTA

should possess. Demonstrating competency in skills included in each checklist assures the clinical community

that the PTA student is competent and safe to interact with patients.

In addition to the skills checklists, practical exams will be used to assess students' safety and competency level.

The practical exam will allow students to incorporate the skills they have learned into a simulated

comprehensive treatment session based on physical therapy plans of care.

Purpose

This booklet will be distributed to students during the program orientation at the start of the third semester and

contains a comprehensive list of the skills that students must demonstrate competency in for each lab course. It

also contains the criteria for competency requirements of each skill. Skills Checklists are used as a formative

assessment in each laboratory course. Students MUST demonstrate competency in each skill, which includes

adherence to critical safety/performance elements, as determined by the lab instructor. Scheduled times outside

of regular class time will be made available for students to demonstrate competency of each skill, if necessary.

The students are responsible for making sure they have completed all skills and received evaluator’s signatures

on the checklist prior to terminal practical examination for each course. Students MUST successfully complete

each Skills Checklist for laboratory courses in order to pass the course, and progress through the program.

Students will have the opportunity to practice the skills during lab time and are encouraged to spend extra time

on skills as necessary.

Critical Safety Skills/Performance Elements

Critical Safety Skills/Performance Elements are those components of a skill that are vital to the competent

performance of the intervention and to ensure the safety of the patient. Although each intervention may have

specific critical elements, there are Critical Safety Skills that are common to numerous skills throughout the

curriculum. Failure to complete a Critical Safety Skills/Performance Element during a skill check or during

a practical examination will result in failure of that skill or the exam.

Grading

Performance of each skill will be graded on a pass/fail basis: Fail (F = 75%) and Pass (P = 100%).

o In order to be deemed competent and pass, a student must receive a P for each skill and for the

critical safety elements required of each.

o Students will have a maximum of 3 attempts to demonstrate competency.

o A student will be remediated after each unsuccessful attempt and an action plan will be written.

o If more than one attempt is needed, the students’ grade will be the average of all attempts.

o A student who does not demonstrate competency on any skill after 3 attempts, WILL BE

REQUIRED TO WITHDRAW FROM THE COURSE AND WILL NOT BE ALLOWED

TO PROGRESS IN THE PROGRAM.

3

If the preceding occurs after the JC withdrawal date, the student can remain in the class,

but will not complete any future skills nor will they participate in the practical exam, and

they will receive an “F” in the course.

** This is a working document and is subject to change. Students will be notified of any changes during

specific courses.

4

Johnson College Physical Therapist Assistant Program

SKILLS CHECKLIST FOR PTA 152 PATIENT CARE

Student Name____________________________

The student has completed the necessary coursework, has practiced reviewed interventions under the supervision of the

instructor in the laboratory, and has passed a Competency Skills Checklist for the following skills:

SKILL Date Grade EVALUATOR INITIALS

Infection Control/Vital Signs

Hand Hygiene

Aseptic Technique

Donning/Doffing Appropriate

Protective Isolation Equipment

Temperature

Respirations

Pulse

Blood Pressure

Body Mechanics and Posture Education

of a Peer

Lift using Proper Body Mechanics

Height, Weight, Length, & Girth

Measurements

Transfers

Bed Mobility

Draping and Positioning for patient

dignity

One person-Wheelchair to/from bed-

side scoot

One person-Stand/Pivot & Sliding

Board Transfers

Two person- Wheelchair to/from bed

Three person-Stretcher to/from bed

Hydraulic Lift Transfers

Application/Adjustment of Assistive Devices/Equipment

Hospital Bed

Raised toilet seat

5

Canes

Crutches

Walkers

Wheelchair

Long handled reacher

Functional Activities

Gait Training with walker & rolling

walker

Gait Training will axillary/forearm

crutches (variety of patterns)

Gait Training with Various Canes

Stair Climbing

Wheelchair management and

mobility(varied surfaces & terrain)

Wheelchair adjustments for posture and

function

Evaluator will sign only when student demonstrates competency at that skill.

EVALUATOR

SIGNATURE/DATE:___________________________________________________________

6

Student Name: _________________________________

SKILL: HAND HYGIENE

Hand Rubbing Attempt

1

Attempt

2

Attempt

3

Remove jewelry

Apply agent to palm

Rub vigorously for at least 15 seconds or until hands are dry

Hand Washing

Remove jewelry

Turn on water and adjust to warm

Apply soap

Rub vigorously for 30 seconds

Rinse from wrists to fingers in a downward direction

Dry hands thoroughly

Shut water off with paper towel and discard

SKILL: ASEPTIC TECHNIQUES

Application/removal of sterile gloves Attempt

1

Attempt

2

Attempt

3

Perform hand washing as previous

Carefully open package

DO NOT touch the outside of the gloves – they are sterile!

Grasp the inner side of the 1st glove, insert your hand and fingers,

allow the glove to remain folded/cuffed on bottom

Lift the 2nd glove by sliding your gloved fingers between the

underside of the cuff and the outer side of the palm of the 1st glove

Pull cuff of 2nd glove up by holding outer surface of cuff

Once second glove is in place you can slide finger under cuff of 1st

glove to pull up

7

Student Name: ________________________________________________

SKILL: DONNING/DOFFING APPROPRIATE PROTECTIVE ISOLATION EQUIPMENT

Donning Attempt

1

Attempt

2

Attempt

3

Gown

Fully cover torso from neck to knees, arms to end of wrist, and wrap

around the back

Fasten in back at neck and waist

Mask or Respirator

Secure ties or elastic band at middle of head and neck

Fit flexible band to nose bridge

Fit snug to face and below chin

Gloves

Use non-sterile for isolation

Select according to hand size

Extend to cover wrist of isolation gown

Doffing

Gloves `

Outside of gloves are contaminated!

Grasp outside of glove with opposite gloved hand; peel off

Hold removed glove in gloved hand

Slide fingers of ungloved hand under remaining glove at wrist

Gown

Gown front and sleeves are contaminated!

Unfasten neck, then waist ties

Remove gown using a peeling motion; pull gown from each shoulder

toward the same hand

Gown will turn inside out

Hold removed gown away from body, roll into a bundle and discard

into waste or linen receptacle

Mask or Respirator

Front of mask/respirator is contaminated – DO NOT TOUCH!

Grasp ONLY bottom then top ties/elastics and remove

Discard in waste container

8

Hand Hygiene

Perform hand hygiene immediately after removing all PPE!

9

Student Name: ______________________________

SKILL: VITAL SIGNS

Temperature Attempt

1

Attempt

2

Attempt

3

Perform hand hygiene and obtain equipment

Explain procedure to the patient

Turn on the unit and apply disposable cover

Instruct patient to open mouth and position probe under tongue,

instruct patient to close mouth and leave probe under tongue

Remove probe when alarm sound is heard and record results.

Pulse

Perform hand hygiene and obtain equipment to measure seconds


Select an appropriate arterial site and firmly but gently place 2-3

finger tips over the artery

AVOID using your thumb – you may perceive your own pulse

Measure for 60 seconds to reduce the risk of error

Record the results in beats per minute

Blood Pressure

Perform hand hygiene and obtain equipment


Expose the antecubital space if able and position patients arm at heart

level or slightly below

Palpate the brachial pulse for a reference point to place the diaphragm

of the stethoscope

Apply the deflated cuff to the arm with center of the bladder over the

medial aspect of arm and approximately 2.5 cm about antecubital

space

Apply stethoscope to your ears and place diaphragm over brachial

artery

Inflate cuff to approximately 180 mmHg

Release the valve on the inflation bulb to allow the needle to drop at

2-3 mmHg per second

Listen for Korotkoff’s sounds to hear systolic and diastolic values

Record values with systolic # first – eg. 120/80

Respirations

Perform hand hygiene and obtain equipment to measure seconds

10

Explain procedure to the patient but may be more accurate if you

don’t explain

Measure for 30 seconds and multiply by 2

Record results in respirations per minute

11

Student Name: ____________________________________

SKILL: BODY MECHANICS

Attempt

1

Attempt

2

Attempt

3

Peer Education

Educate a fellow classmate on proper lifting and body mechanics

Lift using proper body mechanics for the following lifts:

Deep Squat

Hips below knees

Feet straddling the object

Arms parallel to each other

Grasp opposite sides, handles, or under bottom

Maintain vertical trunk and lumbar spine in lordosis with anterior

pelvic tilt

Power Lift

Half squat so hips above knees

Feel parallel to each other and behind the object


Grasp opposite sides, handles, or bottom surface

Maintain a more vertical trunk and lumbar spine in lordosis with

anterior pelvic tilt

Straight leg lift

Knees slightly bent or straight

Lower extremities either parallel to each other or straddling the object


Grasp opposite sides of object

Trunk vertical or horizontal

Lumbar spine remains in lordosis

Golfer’s Lift

Used to lift light objects

Face object

Anterior/posterior positioning of feet

Weight shifted to forward leg

Partially flex hip and knee on weight-bearing leg

12

Extend non-weight-bearing leg

Lift object as if removing a golf ball from the cup

Stoop Lift

Partially flex hips and knees

Maintain normal lordosis of the lumbar spine

Grasp object with hands

Use legs to raise body and object, keeping object close to the body

13

Student Name: _______________________________

SKILLS: TRANSFERS Critical Safety Skills/Performance Elements Attempt

1

Attempt

2

Attempt

3

Wash hands using appropriate technique before and after patient care

Set up treatment area appropriately to ensure safety (acquires

equipment & supplies, disinfects and inspects equipment, space

ensures privacy).

Maintains proper body mechanics during intervention.

Introduces self to patient, confirms identity, and requests permission

to treat

Safely and appropriately assists the patient on/off and to/from the

treatment surface maintaining all precautions and restrictions (follows

appropriate procedures for transfers and guarding)

Conducts oneself in a manner that adheres to professional, ethical

and legal standards during interactions (also includes dress,

communication)

Ensures patient is positioned and draped appropriately to ensure

patient comfort and modesty

Educates the patient about the importance of proper positioning, about

positions that can aggravate or relieve altered sensations, and about

positions that can cause skin trauma.

Bed Mobility

Assist a classmate in rolling from supine <-> sidelying & supine

<-> sit


Use proper hand placement on shoulder and pelvis/hip, roll peer

toward you

With legs slightly flexed, roll patient to sidelying as previous,

elevate patients trunk by lifting under shoulders or by instructing

patient to push up using arms; simultaneously assist with legs by

gently grasping under patients thigh to pivot legs over edge of bed.

One Person Transfers

Wheelchair to/from bed

Side Scoot Method


Position wheelchair midway between head and foot of bed

Wheelchair should be locked and leg rests removed or swung away

Caregiver should be in front and slightly to the side

Armrest nearest the bed should be removed an patients feet on

floor

14

While holding gait belt, instruct patient to lean forward and look

away from the bed; assist patient to push up to unweight buttocks;

swing buttocks over to bed

Repeat previous step if not fully on bed

Stand/Pivot Method

Explain procedure to patient




While holding gait belt, instruct patient to lean forward and to use

armrest to stand

Patient is assisted in turning or pivoting to surface to which he/she

is being transferred

Instruct patient to reach back with hands to feel for surface before

sitting

Sliding Board Method





Armrest nearest the bed should be removed and patients feet on

floor

Assist patient in positioning transfer board under the thigh in front

of drive wheel; it should extend from wheelchair seat to bed

While holding gait belt, instruct patient to lean forward and look

away from bed; instruct and assist patient to push up with arms to

unweight buttocks and move toward bed

Repeat previous step if not fully on bed

Dependent Transfer

Wheelchair to/from bed

2 Person Lift




1st Caregiver should be in front and slightly to the side, 2nd

caregiver should be behind the wheelchair and near bed

Armrest nearest the bed should be removed

15

The 1st person squats down in front of patient and grasps under

both thighs while 2nd person reaches through the axillae and grasps

either patient forearms (if folder) or gait belt

2nd person (behind) ensures that everyone is ready and counts “1,2,

3 lift”; the 2 persons simultaneously lift the patient

The 2 persons carefully readjust the patient if needed for safety and

comfort over edge of bed

Stretcher – 3 person


Lock the bed

Position the bed flat (if the patient can tolerate being supine) and at

the height of the stretcher

Position at least one caregiver on each side of the bed

Move the patient to the side of the bed where the stretcher will be

placed by rolling up the draw sheet close to the patient’s body and

pulling

Align the patient’s legs and head with her trunk

Position stretcher next to the bed and lock stretcher

Caregiver on the side of the bed opposite the stretcher uses draw

sheet to turn the client away from the stretcher; the other caregiver

places the transfer board with a friction-reducing device such as a

transfer roller sheet against the patient’s back, halfway between the

bed and the stretcher

1 Caregiver makes sure everyone is ready for transfer and counts

“1, 2, 3”

Caregivers use draw sheet to slide the patient across the transfer

board onto the stretcher

1 caregiver rolls the patient away from the bed and the other

caregiver removes the board and transfer roller sheet

Reposition the patient on the stretcher for comfort and alignment;

provides a blanket if needed

Hydraulic Lift


Place sling under upper trunk and buttocks; upper thighs by rolling

patient onto one side and then the other

Crisscross thigh straps of sling

Position lift close to bed with legs of base spread wide and

spreader bar over patient’s chest by opening control valve; attach

appropriate web straps to spreader bar

Close the control valve and check all attachments before lifting

patient

Instruct patient to fold arms if able and not to grab the spreader bar

Elevate patient by pushing down on pump handle until patients

buttocks clear the surface of the bed; adjust thigh straps if needed

16

Transport patient to wheelchair and position so buttocks is over

wheelchair

1st caregiver is in front giving some posterior pressure to help align

into more seated posture while slowly opening control valve.

Simultaneously the 2nd caregiver is pulling up on posterior trunk

strap to assist in seated alignment

Unhook all straps from spreader bar and move lift away from

patient

Adjust patient posture and alignment if needed

17

Student Name: ______________________________

SKILL: GAIT TRAINING

Critical Safety Skills/Performance Elements Attempt

1

Attempt

2

Attempt

3




ensures privacy).



to treat

Interprets the physical therapy POC correctly and identifies

contraindications/precautions for the given intervention



communication)


treatment surface maintaining all precautions and restrictions

(follows appropriate procedures for transfers and guarding)


patient comfort and modesty (utilizes pillows, wedges, sheets,

towels, etc)

Educates the patient about the importance of proper positioning,

about positions that can aggravate or relieve altered sensations, and

about positions that can cause skin trauma.

Monitors and adjusts intervention in response to patient status,

clinical indicators, and notifies appropriate individuals as necessary

Gait Training

Teach a peer the following functional activities using a 2 pt.,

modified 2 pt., 4 pt., modified 4 pt., 3 pt. and 3-one point gait

pattern. Incorporate instruction of WBAT, PWB and NWB if

applicable to patient scenario. Guard patient according to level of

assistance needed in scenario

o Gait training with standard and rollator walker

o Gait training with axillary and forearm

crutches

o Gait training with various canes

o Stair climbing

Guard patient according to level of

assistance needed in scenario

Guard in back when patient ascends

steps in front when patient descends

steps

18

Proper instruction if WB restrictions

apply

Instruct in use of proper handrail and/or

device according to scenario

Student Name: _____________________________________

SKILL: WHEELCHAIR ACTIVITIES


1

Attempt

2

Attempt

3


Set up treatment area appropriately to ensure safety (acquires equipment &

supplies, disinfects and inspects equipment, space ensures privacy).


Introduces self to patient, confirms identity, and requests permission to treat

Safely and appropriately assists the patient on/off and to/from the treatment

surface maintaining all precautions and restrictions (follows appropriate

procedures for transfers and guarding)

Conducts oneself in a manner that adheres to professional, ethical and legal

standards during interactions (also includes dress, communication)

Ensures patient is positioned and draped appropriately to ensure patient

comfort and modesty


positions that can aggravate or relieve altered sensations, and about positions

that can cause skin trauma.

Fitting a Wheelchair

Adjust a wheelchair to fit a classmate for proper posture and function

Seat Height and Leg Length

Foot plate 2” from floor; 2-3 fingers fit under thigh and seat upholstery

with hand parallel to floor

Seat Depth

2-3 fingers fit between front seat edge and popliteal fold, hand parallel to

floor

Seat Width

Easily slide hands vertically between thighs and clothing guard on arm rest,

slight contact with each

Back Height

With hand vertical, 4 fingers fit under axilla and above upholstery

Armrest Height

Shoulders level when elbows are supported, able to bear weight on

forearms while at rest

19

Wheelchair Mobility

Propel a wheelchair with 2 hands, 1 hand/1 leg, and 2 legs; inclines and

ramp; open/close doors

Instruct peer on hand placement and/or leg placement for forward and

backward propulsion and turning

Instruct peer on hand placement and/or leg placement and truck position to

propel a wheelchair on inclines/ramps

Instruct peer on hand placement and/or leg placement for opening and

closing doors

SKILL: ADJUST AND FIT ASSISTIVE DEVICES Critical Safety Skills/Performance Elements Attempt

1

Attempt

2

Attempt

3










comfort and modesty




Application / adjustment of assistive device for proper fit and safety

Raised Toilet Seat

Long Handled Reacher

Canes

Position the cane tip approximately 2 inches lateral and 4 to 6 inches

anterior to the toe of the shoes

Determine fit in standing or supine; the hand grip should be placed at

patients greater trochanter, the wrist crease, or the ulnar styloid with the

arm straight along the body

Axillary / Forearm Crutches

Position the crutch tips approximately 2 inches lateral and 4 to 6 inches

anterior to the toe of the shoes

To determine hand grip: in standing or supine; the hand grip should be

placed at patients greater trochanter, the wrist crease, or the ulnar styloid

with the arm straight along the body

20

Forearm crutches – the top of the forearm cuff should be located 1.0 –

1.5 inches distal to the olecranon process when the patient grips the hand

piece

Axillary crutches – should be evaluated for space between the axilla rest

and floor of the axilla; it should be approximately 2 inches to prevent

nerve damage

Standard Walkers and Rollator Walkers

Position walker in front of patient with rear tips of walker opposite the

mid portion of the feet

Determine fit in standing; the hand grip should be placed at patients

greater trochanter, the wrist crease, or the ulnar styloid with the arm

straight along the body

21

Johnson College

Physical Therapist Assistant Program

SKILLS CHECKLIST FOR PTA 154 PHYSICAL THERAPY PROCEDURES

Student Name____________________________



SKILL Date Grade Evaluators Initials

Pain Scales

Heat Modalities

Hot Pack

Paraffin Bath

Cryotherapy

Cold Pack/Ice Pack

Ice Massage

Vapocoolant Spray

Diathermy

Short wave pulsed

Short wave continuous

Ultrasound

Continuous

Pulsed

Electromagnetic Agents

UV

Infrared

Traction (intermittent, sustained)

Lumbar Mechanical

Cervical Mechanical

Electrical Agents

E-Stim for pain management

E-Stim for Muscle Contraction

E-Stim for Tissue Healing

Biofeedback

Evaluator Signature: ____________________________ Date: _________________

22

Student Name: _________________________________

SKILL: PAIN ASSESSMENT

Attempt

1

Attempt

2

Attempt

3

Perform hand hygiene and obtain appropriate pain scale

Ask the patient to rate pain based on the scale you chose

Record results such as location, duration and intensity

SKILL: HOT PACK APPLICATION Critical Safety Skills/Performance Elements Attempt

1

Attempt

2

Attempt

3














comfort and modesty (utilizes pillows, wedges, sheets, towels, etc)

Monitors and adjusts intervention in response to patient status, clinical

indicators, and notifies appropriate individuals as necessary

Application Technique Attempt

1

Attempt

2

Attempt

3

Explains the procedure, purpose, and duration to the patient

Examines the patient’s skin and sensation prior to initiating treatment and

removes any jewelry from the treatment area

Provides patient with call bell while hot pack is on and instructs patient to

call immediately if experiencing any discomfort

Wraps hot pack in 6-8 layers of toweling.

Apply and secure hot pack to ensure patient comfort

Inquires about patient comfort and sensation after 5 minutes.

After the treatment, examines the patient’s skin and reassesses progress

toward goals.

23

Student Name: ______________________________

SKILL: PARAFFIN APPLICATION


1

Attempt

2

Attempt

3

















Application Technique (Dip Wrap Method for Wrist/Hand) Attempt

1

Attempt

2

Attempt

3

Explains the procedure, purpose, and duration (10-15 minutes) to the patient



Provides patient with call bell while hot pack is on and instructs patient to


With fingers apart, dip the hand into the paraffin as far as possible and

remove. Advise patient to avoid moving the fingers during the treatment and

to avoid touching the sides and bottom of the tank, wait briefly for paraffin

to harden.

Redip the hand as described above 6-10 times

Wrap the patient’s hand in a plastic bag and then with a towel.

Instruct patient not to move the hand during the 10-15 minutes

After the treatment, peel off paraffin using the plastic bag, examine the

patient’s skin and reassess progress toward goals.

24

Student Name: ___________________________________

SKILL: COLD PACK APPLICATION


1

Attempt

2

Attempt

3

















Application Technique




Provides patient with call bell while cold pack is on and instructs patient to


Wraps cold pack in plastic bag or pillow case

Apply and secure cold pack to ensure patient comfort

After the treatment, examines the patient’s skin and reassesses progress

toward goals.

25

Student Name: ____________________________________

SKILL: ICE MASSAGE APPLICATION


1

Attempt

2

Attempt

3


















1

Attempt

2

Attempt

3




Place towel around treatment area to absorb any excess water

Rub ice over treatment area using small overlapping circles until patient

experiences analgesia

After the treatment, examines the patient’s skin for signs of adverse effects

such as welts or rash. Normal response is pink or dark pink. Reassesses

progress toward goals.

26

Student Name: _______________________________________

SKILL: VAPOCOOLANT SPRAY APPLICATION Critical Safety Skills/Performance Elements Attempt

1

Attempt

2

Attempt

3


















Explains the procedure, purpose, and duration to the patient



Identify trigger point and associated tight muscles

Cover patient’s eyes, nose, and mouth to minimize inhalation of the spray.

Hold the spray 12-18 inches from the skin and angles so spray hits skin at

about 30 degrees

Apply 2-5 parallel sweeps of the spray, 0.5-1 inch apart at a speed of

approximately 4 inches/second in the direction of the muscle fibers.

Continue until the entire muscle has been covered including the muscle

attachment and trigger point. Maintain gentle steady tension on the muscle

during the treatment to ensure a stretch.

Immediately after cooling, instruct patient to perform a gentle passive

stretch while exhaling.

After the treatment, examines the patient’s skin for signs of adverse effects

such as welts or rash. Reassesses progress toward goals.

27

Student Name: __________________________________

SKILL: Ultrasound


1

Attempt

2

Attempt

3


















Attempt

1

Attempt

2

Attempt

3

Explains the procedure and the purpose to the patient

Applies conduction medium to treatment area

Sets up appropriate tx parameters gives appropriate rationale for each if asked

Operates ultrasound device appropriately and safely

Maintains continuous contact and movement of the sound head with the patient’s

skin

Limits the size of the treatment area appropriately

Inquires about patient comfort and sensation

Removes conduction medium, examines skin, and reassesses progress toward

goals, after treatment

28

Student Name: ___________________________

WRITTEN COMPETENCY: DIATHERMY

1. What diagnosis/ condition would you use pulsed SWD? List 2.

2. What diagnosis/ condition would you use thermal SWD? List 2.

3. List 3 contraindication to using diathermy.

4. Explain how you set a patient up for diathermy that had a hamstring contracture.

Evaluator Signature: _____________________________________________

29

Student Name: _______________________________

WRITTEN COMPETENCY: ULTRAVIOLET RADIATION

PASS FAIL

Establishes appropriateness of ultraviolet radiation by assessing for

relevant contraindications and precautions. List Precautions and

Contraindications:

Explains the procedure and its purpose to the patient

Examines the patient’s skin before treatment; describe what you are

checking for:

Selects the appropriate lamp. Gives an appropriate rationale for this

selection. If this is not an initial tx, explain how you would select

lamp.

Positions the patient appropriately. Briefly Explain:

Selects the appropriate treatment parameters. Gives an appropriate

rationale for the selection of the following parameters:

a. Relationship to MED and individual’s skin sensitivity response.

30

b.Treatment duration

c. Distance of lamp from the patient’s skin

Evaluates the patient’s response and adjusts treatment as necessary

and appropriate. Describe what you would be looking for:

After the treatment, examines the patient and reassesses progress

toward goals.

Evaluator Signature: __________________________________ Date: ________________

31

Student Name: ______________________________

WRITTEN COMPETENCY: LIGHT THERAPY

PASS FAIL

Establishes appropriateness of light therapy by assessing for relevant

contraindications and precautions. List contraindications and

precautions:

Explains the procedure and its purpose to the patient:

Examines the patient’s skin before treatment. Briefly explain what

you would be looking for:

Preparation before treatment. Describe what to do before beginning

treatment:

Positions the patient and device appropriately. Explain:

Inquires about patient comfort and sensation. Evaluates the patient’s

response and adjusts treatment as necessary and appropriate.

32

After the treatment, examines the patient and reassesses progress

toward goals.

Evaluator Signature: _______________________________ Date: ____________________

33

Student Name: ________________________________

SKILL: TRACTION Critical Safety Skills/Performance Elements Attempt

1

Attempt

2

Attempt

3




ensures privacy).



to treat





communication)





patient comfort and modesty (utilizes pillows, wedges, sheets, towels,

etc)






Traction Procedure Attempt

1

Attempt

2

Attempt

3


Positions the patient appropriately.

Cervical: Selects the appropriate treatment parameters for when

using mechanical traction. Gives an appropriate rationale for the

following:

a. Force (s)

b. Hold/relax times

c. Total traction time

Lumbar: Selects the appropriate treatment parameters for when

using mechanical traction. Gives an appropriate rationale for the

following:

a. Force (s)

b. Hold/relax times

c. Total traction time

Operates the selected device or applies the selected technique

appropriately and safely.

34

Student Name: ______________________________

SKILL: E-STIM FOR PAIN MANAGEMENT


1

Attempt

2

Attempt

3




ensures privacy).



to treat





communication)






etc)






E-STIM FOR PAIN MANAGEMENT Attempt

1

Attempt

2

Attempt

3


Examines the patient’s skin before treatment

Prepares skin for electrode placement


rationale for each of these parameters:

a. Electrode placement

b. Waveform

c. Frequency/Pulse rate

d. Pulse Duration

e. Intensity

Operates device appropriately and safely.

Evaluates the patient’s response and adjusts parameters as

necessary and appropriate.

After the treatment examines the patient’s skin and reassesses


35

Student Name: ________________________________

SKILL: E-STIM FOR MUSCLE CONTRACTION


1

Attempt

2

Attempt

3




ensures privacy).



to treat





communication)






etc)






E-STIM FOR MUSCLE CONTRACTION Attempt

1

Attempt

2

Attempt

3





rationale for each of these parameters:

a. Electrode placement

b. Waveform


d. Pulse Duration

e. Intensity


Evaluates the patient’s response and adjusts parameters as

necessary and appropriate.

After the treatment examines the patient’s skin and reassesses


36

Student Name: _____________________________

SKILL: E-STIM FOR TISSUE HEALING


1

Attempt

2

Attempt

3




















E-STIM FOR TISSUE HEALING Attempt

1

Attempt

2

Attempt

3




Selects the appropriate treatment parameters. Gives an appropriate rationale

for each of these parameters:

a. Electrode Placement

b. Waveform


d. Pulse Duration

e. Intensity


Evaluates the patient’s response and adjusts parameters as necessary and

appropriate.

After the treatment examines the patient’s skin and reassesses progress

toward goals.

37

Student Name: _____________________________

SKILL: Biofeedback


1

Attempt

2

Attempt

3




















Biofeedback Attempt

1

Attempt

2

Attempt

3



Prepares skin for electrodes

Selects the appropriate treatment parameters. Gives an appropriate rationale

for each of these parameters:

a. Electrode Placement

b. Gain Setting

c. Threshold Setting

d. Alarm Settings if applicable


Evaluates the patient’s response and adjusts parameters as necessary and

appropriate.


toward goals.

38

Johnson College


SKILL CHECKLIST FOR PTA 156 INTRODUCTION TO THERAPEUTIC EXERCISE

Student Name: _____________________________________



Skill Date Grade Evaluator Initials

Stretching

Closed Chain Exercises

Open Chain Exercises

Concentric Exercises

Eccentric Exercises

Isometric

PNF

Other

Therapeutic Massage

Aerobic Capacity

Balance

Posture/Core Stabilization

Aquatic/Hydrotherapy

Evaluator Signature _____________________________________________

39

Student Name: ___________________________________

SKILL: THERAPEUTIC MASSAGE


1

Attempt

2

Attempt

3


















1

Attempt

2

Attempt

3



Applies massage lotion to the treatment area.

Apply Hoffa Massage with steady rhythm

Start and finish session with effleurage stroke from distal to proximal in a

tree like hand motion

Apply petrissage stroke of kneading type motion where muscle is lifted and

rolled

Apply tapotement stroke as a series of percussions with cupped hands

Apply vibration stroke of rapid oscillations of hands and a firm contact with

the skin

Apply transverse friction massage to a slightly stretched tendon or ligament

using a deep pressure and 2 fingers. No lubricant is used.

Evaluates the patient’s response and adjusts massage intensity as necessary

and appropriate.

Inquires about patient comfort and sensation.


toward goals. Cleans lotion from skin.

40

Student Name: ______________________________________

Skill: Stretching Procedure

Attempt

1

Attempt

2

Attempt

3

Explains the purpose of stretching and parameters

Demonstrates an example of passive stretching

Educates peer/patient on self-stretching technique

Skill: Open Chain Exercise

Attempt

1

Attempt

2

Attempt

3

Explains the purpose of open chain exercise and parameters that may be

used

Demonstrates an example of open chain exercise

Educates peer/patient on open chain exercise

Skill: Closed Chain Exercise

Attempt

1

Attempt

2

Attempt

3

Explains the purpose of closed chain exercise and parameters that may be

used

Demonstrates an example of closed chain exercise

Educates peer/patient on closed chain exercise

Skill: PNF Procedure: Attempt

1

Attempt

2

Attempt

3


Supports the limb through available ROM; uses appropriate hand

placement, and provides appropriate manual and verbal cues

Appropriate diagonal pattern used for D1 flexion/extension & D2

flexion/extension for UE Patterns

Appropriate diagonal pattern used for D1 flexion/extension & D2

flexion/extension for LE Patterns

Encourages the patient to participate as much as possible in the treatment

41

Student: _______________________ Date: ____________________

Patient name: __________________

A. Take your partners radial or carotid pulse and respirations for 60 seconds.

i. RECORD THE RESULTS IN THE TABLE

B. Calculate your partners max HR (220-age) & target HR for 50% and 70% ( Max HR x 0.50 and Max

HR x0.70:

i. RECORD THE RESULTS IN THE TABLE

C. Ask you partner to perform an aerobic exercise (bike, treadmill, elliptical, stairs, jogging, etc.) for 6

minutes without resting at a challenging but tolerable rate.

D. Visually monitor your partner’s response to exercise.

a. Did their coloring change?______________________________

b. Breathing heavier? ____________________________________

c. Results of talk test? ____________________________________

d. Ask your partner to rate their perceived excursion on the Borg Scale:

____________________________________________________

E. AFTER 6 MINUTES OF AEROBIC TE, ALLOW YOUR PARTNER TO SIT AND TAKE PULSE

AND RESPIRATIONS.

Pre-test Post-test ( 3 min)

Resting Pulse

Resting Respirations

Max HR

Target HR 50%

Target HR 70%

F. Did you partner reach their Target HR or Max HR during this aerobic activity?

42

Student Name: ___________________________________

Skill: Core Stabilization Procedure Attempt

1

Attempt

2

Attempt

3


Appropriate MC’s and VC’s as needed to assist patient in finding their

neutral spine and activate transverse abdominus.

Instruct patient to maintain neutral spine while move UE or LE in small

increments.

Progresses the TE program as per patients response and request

After the treatment, examines the patient and reassesses progress toward

goals.

HYDROTHERAPY-WHIRLPOOL Attempt

1

Attempt

2

Attempt

3



Selects the appropriate water temperature. Gives an appropriate rationale

for this selection.

Instructs the patient in appropriate activities to perform while in the water,

e.g., AROM.

Selects the appropriate treatment duration. Gives an appropriate rationale

for this selection.

Inquires about patient comfort and sensation.

Evaluates the patient’s response and adjusts treatment as necessary and

appropriate.


goals.

43

WRITTEN COMPETENCY: CONTRAST BATH FOR EDEMA

1. At what temperature (F) should the warm bucket be? ________________________

2. At what temperature (F) should the cold bucket be? _________________________

3. First immerse the area in _______________ water for __________________minutes; then immerse the

area in ________________water for _____________________minutes;

4. Repeat this process for _______________minutes (total treatment time).

5. End with the area immersed in ________________water.

6. Contraindications?____________________________________________________________________

____________________________________________________________

Evaluator Signature: ________________________________________________

44

Johnson College


PTA 224 SKILL CHECKLIST

Student Name:

REGION ROM MMT GRADE DATE

Shoulder

Elbow

Wrist/Hand

Neck/Trunk

Hip

Knee

Ankle/Foot

Evaluator Signature: _________________________________________

45

Attempt 1 Attempt 2 Attempt 3

NAME: ____________________________________________ DATE: _________________________

MOTION

PASS FAIL PASS FAIL PASS FAILAG: Ankle dorsiflexion Tibialis anterior

GE: Ankle dorsiflexion

AG: Ankle plantarflexion Gastrocnemius, soleus

GE: Elbow extension

AG: Supination /inversion Tibialis posterior

GE: Supination /inversion

AG: Pronation/eversion Peroneus longus & brevis

GE: Pronation/eversion

Comments:

Evaluator's Signature:

PTA 224 - ANKLE MMT SKILLS CHECKLIST

MS RESPONSIBLE FOR

ACTIONMMT GRADE

46


NAME: ____________________________________________ DATE:

PASS FAIL

PALPATION: Head of fibula, anterior border of tibia, achilles tendon, medial malleolus

lateral malleolus, tuberosity of the navicular bone, base of fifth metatarsal head,

head of 1st metatarsal , calcaneous

ROM

NORMAL

VALUE

PRIMARY

MUSCLE

PASS FAIL PASS FAIL PASS FAILAnkle dorsiflexion 0*-20* Tibialis anterior

Ankle plantarflexion 0*-50* Gastrocnemius, soleus

Supination /inversion 0*-35* Tibialis posterior

Pronation/ Eversion 0*-15* Peroneus longus & brevis

Comments:


PTA 224 - ANKLE RANGE OF MOTION SKILLS CHECKLIST

PLACEMENT/

MEASUREMENT

USING GONI

47


NAME: ____________________________________________ DATE:

PASS FAIL

PALPATION: Greater trochanter, patella, ligamentum patellae tendon, tibial tuberosity,

tibial plateau, head of fibula, lateral malleolus, lateral epicondyle of the femur

ROM

NORMAL

VALUE

PRIMARY

MUSCLE

PASS FAIL PASS FAIL PASS FAILKnee flexion, supine 0*-135* (HS)Biceps femoris, semitendinosus,

semimembranosus

Knee extension, supine 0* (quads) Rectus femoris, vastus

intermedius, lateralis, & medialis

Comments:

MOTION

PASS FAIL PASS FAIL PASS FAILAG: Knee flexion (HS)Biceps femoris, semitendinosus,

GE: Knee flexion semimembranosus

AG: Knee exten. (quads) Rectus femoris, vastus

GE: Knee exten. intermedius, lateralis, & medialis

Comments:


PTA 224 - KNEE RANGE OF MOTION & MMT SKILLS CHECKLIST

PLACEMENT/

MEASUREMENT

USING GONI

MMT MS RESPONSIBLE FOR ACTION

48


NAME: ____________________________________________ Date: ________________

MOTION

PASS FAIL PASS FAIL PASS FAILAG: Hip flexion Iliopsoas

GE: Hip flexion

AG: Hip flex, abd, ER, Sartorius

& knee flex

AG: Hip extension Glut max, hamstrings

GE: Hip extension

AG: Hip abd Glut medius, glut minimus

GE: Hip abd

AG: Hip ADD Add. longus, add. brevis,

GE: Hip ADD add. magnus, pectineus,

gracilis

AG: Hip IR Glut medius, glut minimus,

GE: Hip IR TFL

AG: Hip ER Piriformis, obtur. Externus

GE: Hip ER gemellus superior,

quadratus femoris,

gemellus inferior,

obterator internus

Comments:


PTA 224 - HIP MMT SKILLS CHECKLIST

MS RESPONSIBLE FOR

ACTIONMMT GRADE

49


NAME: ____________________________________________ DATE:

PASS FAIL

PALPATION: Iliac crest, ASIS, tubercle of the ilium, PSIS, ischial tuberosity, greater trochanter,

adductor tubercle, lateral epicondyle of the femur, patella, anterior border of

tibia

ROM

NORMAL

VALUE

PRIMARY

MUSCLE

PASS FAIL PASS FAIL PASS FAILHip flexion, supine 0* - 120* Iliopsoas, sartorius

Hip extension, prone 0* - 30* Glut max, hamstrings

Hip abduction, supine 0* - 45* Glut medius, glut minimus

Hip adduction, supine 0* - 30* Add. longus, add. brevis,

add. magnus, pectineus, gracilis

Hip IR, seated 0* - 45* Glut medius, glut minimus, TFL

Hip ER, seated 0* - 45* Piriformis, obtur. Externus, gemellus

superior, quadratus femoris, gemellus

infer., obterator internus

Comments:


PTA 224 - HIP RANGE OF MOTION SKILLS CHECKLIST

PLACEMENT/

MEASUREMENT

USING GONI

50


NAME: ____________________________________________ Date: ________________

MOTION

PASS FAIL PASS FAIL PASS FAILHead/Neck flexion Rectus capitus anterior,

Longus capitus, Longus colli,

Scalenus anterior, Sternomastoid

Head/Neck Sternomastoid

flexion, rot, & lat flex

Head/Neck extension Semispinalis capitis and

cervicis, Rectus capitus posterior major and minor,

Obliquus capitis inferior and superior,

Splenius cervicis and capitis, Longissimus cervicis

and capitis, & iliocostalis cervicis

Trunk flexion Rectus abdominis

Trunk exten. Erector spinae

Pelvic elevation Quadratus Lumborum

Trunk flex & rot External abd obliq &

internal abdom. oblique

Comments:


PTA 224 - NECK & TRUNK MMT SKILLS CHECKLIST

MS RESPONSIBLE FOR

ACTIONMMT GRADE

51


NAME: ____________________________________________ DATE: _________________________

PASS FAIL

PALPATION: Suprasternal notch, thyroid cartilage, hyoid bone, angle of mandible,

TMJ joint, mastoid process, C7 spinous process

ROM

NORMAL

VALUE

PRIMARY

MUSCLE

PASS FAIL PASS FAIL PASS FAILCervical flexion 0* - 45* Rectus capitus anterior,

Longus capitus, Longus colli, Scalenus anterior, Sternomastoid

Cervical extension 0* - 45* Semispinalis capitis and cervicis,

Rectus capitus posterior major and minor,

Obliquus capitis inferior and superior,

Splenius cervicis and capitis, Longissimus cervicis

and capitis, & iliocostalis cervicis

Cervical SB (lateral flexion) 0* - 45* Scalenes, levator scap

Cervical rotation 0* - 60* Sternocleidomastoid,

splenius capitis & cervicis

Lumbar SB (lateral flexion) 0* - 45* Quadratus lumb, ext/int oblique& tape measure

Lumbar flexion Tape Measure Rectus abdominus

Lumbar Exten. Tape Measure Erector Spinae

Comments:


PTA 224 - NECK & TRUNK RANGE OF MOTION SKILLS CHECKLIST

PLACEMENT/

MEASUREMENT

USING GONI

52


NAME: ____________________________________________ DATE:

PASS FAIL

PALPATION: Inion, vertebral border of scapula, inferior angle of scapula, spine of scapula, acromion process

clavicle, coracoid process, brachial pulse, lateral epicondyle of humerus, olecranon process of

ulna, T12 spinous process, sternum

ROM

NORMAL

VALUE

PRIMARY

MUSCLE

PASS FAIL PASS FAIL PASS FAILShoulder flexion, supine & seated 0*-180* Anterior deltoid, coracobrachialis

Shoulder extension, prone & seated 0*-60* Latissimus dorsi, teres major

Shoulder abduction, supine & seated 0*-180* Middle deltoid, supraspinatus

Shoulder Horizontal, ADD, seated 0*-135* Pectoralis major, anterior deltoid

Shoulder Horizontal, ABD, seated 0*-45* Posterior deltoid

Shoulder IR, prone & seated 0*-70* Subscapularis, teres major

Shoulder ER, supine & seated 0*-90* Infraspinatus, teres minor

Comments:


CORRECT

PLACEMENT &

MEASUREMENT

USING GONI

PTA 224 - SHOULDER RANGE OF MOTION SKILLS CHECKLIST

53


NAME: ____________________________________________ DATE: _________________________

MOTION

PASS FAIL PASS FAIL PASS FAILAG: Scap Abd /Lateral rot Serratus Anterior

GE: Scap Abd /Lateral rot

AG: Scapular Elevation Pass/Fail Pass/Fail Pass/Fail Upper Trap & Levator Scap

GE: Scapular Elevation

AG: Scapular Adduction " " Middle Trap

GE: Scapular Adduction

AG: GHJ flexion Anterior deltoid

GE: GHJ flexion

AG: GHJ extension Latissimus dorsi, teres major

GE: GHJ extension

AG: GHJ flexion & add Coracobrachialis

GE: GHJ flexion & add

AG: GHJ abduction Middle deltoid, supraspinatus

GE: GHJ abduction

AG: GHJ horizontal add Pec major, ant deltoid

GE: GHJ horizontal add

AG: GHJ horizontal abd Posterior deltoid

GE: GHJ horizontal abd

AG: GHJ IR Subscapularis, teres major

GE: GHJ IR

AG: GHJ ER Infraspinatus, teres minor

GE: GHJ ER

Comments:


PTA 224 - SHOULDER MMT SKILLS CHECKLIST

MS RESPONSIBLE

FOR ACTIONMMT GRADE

54


NAME: ____________________________________________ DATE: _________________________

MOTION

PASS FAIL PASS FAIL PASS FAILAG: Elbow flexion Biceps & Brachialis

GE: Elbow flexion

AG: Elbow extension Triceps, anconeus

GE: Elbow extension

AG: Supination Supinator & biceps

GE: Supination

AG: Pronation Pronator teres and

GE: Pronation pronator quadratus

Comments:


PTA 224 - ELBOW MMT SKILLS CHECKLIST

MS RESPONSIBLE FOR

ACTIONMMT GRADE

55


NAME: ____________________________________________ DATE: _________________________

PASS FAIL

PALPATION: Acromion process, medial epicondyle of the humerus, lateral epicondyle of the humerus,

Olecranon process, head of the radius, styloid process of the radius, head of the third

metacarpal, head of the ulna, styloid process of the ulna

ROM NORMAL VALUE

PRIMARY

MUSCLE

PASS FAIL PASS FAIL PASS FAILElbow flexion 0* - 150* Biceps

Elbow ext/hyper ext 0* up to 15* hyper Triceps

Supination 0* - 80* to 90* Supinator & biceps

Pronation 0* - 80* to 90* Pronator teres &

pronator quadratus

Comments:


PTA 224 - ELBOW RANGE OF MOTION SKILLS CHECKLIST

PLACEMENT/

MEASUREMENT

USING GONI

56


NAME: ____________________________________________DATE: _________________________

MOTION

PASS FAIL PASS FAIL PASS FAILAG: Wrist flexion Flexor carpi radialis, Flexor carpi ulnaris

GE: Wrist flexion

AG: Wrist extension Extens. carpi radialis longus, extens. carpi

GE: Wrist extension radialis brevis, extensor carpi ulnaris

AG: Ulnar deviation Extensor carpi ulnaris

GE: Ulnar deviation

AG: Radial deviation Extens. carpi radialis longus, extens. carpi

GE: Radial deviation radialis brevis, flexor carpi radialis

Comments:


PTA 224 - WRIST MMT SKILLS CHECKLIST

MS RESPONSIBLE FOR

ACTIONMMT GRADE

57


NAME: ____________________________________________ DATE:

PASS FAIL

PALPATION: Styloid process of ulna, styloid process of radius, metacarpal bones, capitate bone,

pisiform bone, thumb web space, distal palmar crease, proximal palmar crease,

thenar eminence, hypothenar eminence, 1st CM joint

ROM

NORMAL

VALUE

PRIMARY

MUSCLE

PASS FAIL PASS FAIL PASS FAILWrist flexion 0* - 80* Flexor carpi radialis, Flexor carpi ulnaris

Wrist extension 0* - 70* Extens. carpi radialis longus, extens. carpi

radialis brevis, extensor carpi ulnaris

Wrist ulnar deviation 0* - 30* Extensor carpi ulnaris

Wrist radial deviation 0* - 20* Extens. carpi radialis longus, extens. carpi

radialis brevis, flexor carpi radialis

Comments:


PTA 224 - WRIST RANGE OF MOTION SKILLS CHECKLIST

PLACEMENT/

MEASUREMENT

USING GONI

58

Student Name: ___________________________________________


PROFESSIONAL BEHAVIORAL SKILLS ASSESSMENT A Physical Therapist Assistant student is expected to exemplify professional behavior at all times. Student

behavior will be assessed in the middle of each semester. If students demonstrate unacceptable behavior, he/she

will be counseled on the behaviors and ways to make improvements, and will be reassessed. If a student

repeatedly fails to comply with the expected behaviors, dismissal from the program will be considered.

STUDENTS MUST DEMONSTRATE ACCEPTABLE BEHAVIOR IN ORDER TO

PARTICIPATE IN CLINICAL EDUCATION.

Expected Student Behavior Date Acceptable/

Unacceptable Comments

Demonstrates respect/consideration of

faculty/peers

Adheres to attendance policy

Accepts and gives constructive criticism

Communicates professionally verbally

and non-verbally with faculty, peers, and

others

Adheres to PTA dress code in lecture,

laboratory, and in clinical situations

Maintains Personal Hygiene

Adequate preparation and timely

submission of assignments

Actively participates in group

discussions and projects

Student Signature: ___________________________________ Date Reviewed: _______________________

Evaluator Signature: ________________________________

59

Johnson College


Skills Checklist for PTA 256 Interventions in Musculoskeletal

Student Name____________________________

The student has completed the necessary coursework, has practiced reviewed interventions under the supervision

of the instructor in the laboratory, and has passed a Competency Skills Checklist for the following skills:

SKILL Date Grade EVALUATOR

INITIALS **

Develop and instruct a peer/patient on hip/knee/ankle/foot/shoulder/wrist/hand exercise interventions

including ROM, strengthening, flexibility, balance/coordination, endurance, and PRE's, based on the

phase of recovery

Progress, adjust, or discontinue an exercise program for a patient with a musculoskeletal impairment

based on a patient’s response to interventions or positional changes.

Ankle Impairments ( Ex: Sprain,

Achilles Tendinopathy, Plantar Fasciitis,

or Ankle Fx)

Knee Impairments (Ex: ACL, PCL,

MCL, Meniscus, Patellofemoral

Pathology, or TKR)

Hip Impairments (Ex: Femoral Fx, THR,

or Pelvic Fx)

Shoulder Impairments (Ex: Rotator Cuff

Pathology, Instability, Adhesive

Capsulitis,)

Elbow Impairments ( Ex: Lateral

Epicondylitis, Medial Epicondylitis,

Medial Ligament Injury

Wrist Impairments (Ex: Carpal Tunnel,

Fracture)

Demonstrate and instruct a peer on techniques used for ROM, stretching, and isometric and dynamic

stabilization exercises for specific spinal regions and impairments

Back impairments (Ex: Lumbar Disc

Pathologies, Spinal Stenosis, Kyphosis,

Scoliosis, Whiplash, Radiculopathy,

Thoracic Outlet (Inlet) Syndrome)

Educate a peer/patient on movement and weight bearing restrictions following arthroplasty or fixation

of the lower extremity-

Peer Instruction

Evaluator Signature: ______________________________________

60

Student Name: _________________________________

SKILL: MUSCULOSKELETAL INTERVENTIONS

Diagnosis: ________________________________


1

Attempt

2

Attempt

3
















positions that that can aggravate or relieve altered sensations, and about




Musculoskeletal Interventions Attempt

1

Attempt

2

Attempt

3

Develop a peer/patient on hip/knee/ankle/foot/shoulder/wrist/hand/ spine

exercise interventions including ROM, strengthening, flexibility,

balance/coordination, endurance, and PRE's, based on the phase of recovery

(suggested resources https://www.hep2go.com/,

http://www.hepbuilder.com/,

http://www.whyiexercise.com/physical-therapy-exercises.html

or PTA dept. VHI exercise kit can be utilized.)

Include in Hard Copy of Exercise Program:

Picture or drawing (if applicable)

Make sure you include how many reps, sets, and how often to perform.

Also include a statement on caution or when to stop TE; e.g. if pain occurs

Instruct a peer/patient on hip/knee/ankle/foot/shoulder/wrist/hand exercise

interventions including ROM, strengthening, flexibility,


https://www.hep2go.com/

http://www.hepbuilder.com/


61

Student Name: _________________________________


Diagnosis: ________________________________


1

Attempt

2

Attempt

3





















1

Attempt

2

Attempt

3


















62

Student Name: _________________________________


Diagnosis: ________________________________


1

Attempt

2

Attempt

3





















1

Attempt

2

Attempt

3


















63

Student Name: _________________________________


Diagnosis: ________________________________


1

Attempt

2

Attempt

3





















1

Attempt

2

Attempt

3


















64

Student Name: _________________________________


Diagnosis: ________________________________


1

Attempt

2

Attempt

3





















1

Attempt

2

Attempt

3


















65

Student Name: _________________________________


Diagnosis: ________________________________


1

Attempt

2

Attempt

3





















1

Attempt

2

Attempt

3


















66

Student Name: _________________________________


Diagnosis: ________________________________


1

Attempt

2

Attempt

3





















1

Attempt

2

Attempt

3


















67

Johnson College


Skills Checklist for PTA 258 Interventions in Neurology

Student Name____________________________



SKILL DATE GRADE EVALUATOR

INITIALS

Developmental Activities

Developmental Activity Training

Inhibition/Facilitation Techniques

Gross/Fine Motor Milestones

Righting/Equilibrium Reactions

Balance/Vestibular

Balance and Vestibular

Interventions/Data Collection Berg Balance Test

POMA I (Tinetti)

Dix-Hallpike/Epley

Gait Training

Parallel Bars

Overground training

Circuit Training

CVA/ Progressive Neuromuscular Disorders

Postural/Task Analysis

Apply motor learning/NDT

principles

Gait Training/Transfers/Functional

Training

Balance/Coordination Training

Wheelchair/Bed Positioning

Energy Conservation Techniques

SCI

Wheelchair Skills/Training

Transfers

Functional Training

Therapeutic Exercises


TBI

Ranchos Los Amigos Levels

Functional Training


Application/Adjustment of

Protective/Supportive

Devices/Orthotics

Donn/Doff Variety of

Devices/Orthotics

Evaluator Signature: __________________________________________

68

Student Name: _____________________________

SKILL: Developmental Activities


1

Attempt

2

Attempt

3




















Developmental Activities Attempt

1

Attempt

2

Attempt

3

Developmental Activity Training

Design an activity based on a video of a child with a neurological

disorder

Inhibition Techniques

Demonstrate appropriate activities to inhibit tone and abnormal

movement patterns

Facilitation Techniques

Demonstrate appropriate activities to facilitate normal movement

patterns , improved trunk control, or muscle tone

Gross/Fine Motor Skills

Create a grid identifying gross and fine motor milestones

Prepare an educational resource for families

Righting/Equilibrium Reactions

Demonstration of techniques to facilitate righting and equilibrium

reactions

69

Student Name: ___________________________

SKILL: Neurological Impairments


1

Attempt

2

Attempt

3




















CVA; Progressive Neurological Disorders Attempt

1

Attempt

2

Attempt

3

Postural Task Analysis

Analyze a functional movement of an individual and outline

movements that occur at each region of the body and major muscle

group activity

Motor Learning/NDT Principles

Demonstrate techniques on a peer

Gait Training/Transfer Training

Role play with peer

Energy Conservation Techniques

Create a Home Program/Educational handout for a patient with a

progressive neuromuscular disease

Balance/Coordination Training

Develop HEP and demonstrate with peer


Educate a peer and develop a handout for patient/family use

70

Student Name: __________________________________

SKILL: SCI


1

Attempt

2

Attempt

3




















SCI Attempt

1

Attempt

2

Attempt

3

Wheelchair skills/training

Demonstrate "wheely" to pop onto a curb


Educate a peer and provide handout for patient/family use

Gait Training/ Transfers/ Functional Training


HEP to promote strength in specific muscle groups and maintain

flexibility

71

Student Name: ________________________________

SKILL: TBI


1

Attempt

2

Attempt

3




















TBI Attempt

1

Attempt

2

Attempt

3

Ranchos Los Amigos Levels

Create a grid identifying RLA levels with appropriate interventions

for each level

Functional Training

Role play with peer


HEP to promote strength in specific muscle groups and maintain

flexibility

72

Student Name: ___________________________

SKILL: Orthotics


1

Attempt

2

Attempt

3




















Orthotics Attempt

1

Attempt

2

Attempt

3

Don/Doff/Care

Instruct a peer on the appropriate technique to don a MAFO

Instruction on Safe Use

Create an instructional resource for wearing schedule, care, and

skin inspection

73

Student Name: ___________________________________

SKILL: BALANCE/VESTIBULAR


1

Attempt

2

Attempt

3




















Balance/Vestibular Attempt

1

Attempt

2

Attempt

3

Balance and Vestibular Data Collection

Balance and Vestibular Interventions

74

Johnson College


Skills Checklist for PTA 260 Topics in Rehab

Student Name____________________________



SKILL Date Grade EVALUATOR

INITIAL

Airway Clearance Techniques

Forced Expiratory Technique (FET)

Active Cycle of Breathing Techniques

(ACBT)

Airway Clearance Techniques (Cough)

Huffing

Postural Drainage (upper, middle, lower

lobes) with Percussion and Vibration

Breathing Exercises

Diaphragmatic Breathing

Pursed-lip Breathing

Aerobic Capacity and Endurance

Integumentary Management

Positioning

Edema Management/Compression

Categories of Dressings

Application/Removal of Dressings

Data Collection on Wounds

Prosthetics

Skin Integrity

Edema Control

Donn/Doff/Care

Balance/ Therapeutic Exercises

Safety Awareness/Injury Prevention

Pre-gait Activities/Gait Training

Environmental Screening

Home and Work Environment Assessment

Evaluator Signature: _____________________________________________________

75

Student Name: _______________________________

SKILL: Breathing Strategies


1

Attempt

2

Attempt

3




















Breathing Strategies Attempt

1

Attempt

2

Attempt

3

Forced Expiratory Technique (FET)

Instruct pt to to take a medium breath

Tighten abdominal muscles

Huff (expiring forcefully with an open glottis) long enough to mobilize

and remove bronchial secretions without a cough

After 1-2 huffs, relax with gentle diaphragmatic breathing

Active Cycle of Breathing Technique (ACBT)

Cycles of diaphragmatic breathing for 15-30 seconds and thoracic

expansion

Continue cycle until pt feels secretions are ready to remove

Medium sized breath followed by tightening of abdominal muscles

while huffing to remove the secretions

Autogenic Drainage

Pt sits upright

Unsticking phase

o Diaphragmatic breathing then exhale to a low lung volume

o Breathe at a normal volume

Collecting Phase-collections are mobilized to the proximal midsized

airways

o Deeper breathing

Evacuation Phase

76

o Deeper breathing and pt suppresses cough until they cannot hold

it any longer

Coughing

Inspire to a near maximal inspiration

Close the glottis

"Bear Down" by tightening abdominals, perineal, gluteal, and shoulder

depressors to increase intrathoracic and intraabdominal pressures

Open glottis to allow inspire air to forcefully exit

To improve cough:

o Sit leaning forward with neck flexed, arms supported, and feet

firmly planted on the floor

o Apply pressure or vibration to the extrathoracic trachea to elicit a

cough reflex

o Apply pressure to midrectus abdominis area after inspiration

o Apply pressure along lower costal borders during exhalation

Huffing

Instruct pt to take a single large inspiration followed by short expiratory

efforts with pauses in between

77

Student Name: ________________________________

SKILL: POSTURAL DRAINAGE


1

Attempt

2

Attempt

3




















Postural Drainage Attempt

1

Attempt

2

Attempt

3

Positioning-

Right Upper Lobe

o Sitting with back support

Right Middle Lobe

o Supine with foot of bed elevated 12-14"

Right Lower Lobe

o Sidelying on Left with foot of bed elevated 18-20"

Apical posterior Segment Left Upper Lobe

o Sitting with trunk flexed over a pillow

Lingular Inferior Segment Left Upper Lobe

o Supine with foot of bed elevated 12-14"

Left Lower Lobe

o Sidelying on Right with foot of bed elevated 18-20"

Percussion (Tapotement)

Performed in area of thorax corresponding to lung segment being drained

with patient positioned as above

Cup hand and clap rhythmically over area for 2-5 minutes

Vibration

Place hands one on top of the other over area previously percussed

Have pt perform several deep breaths (see ACBT below)

As pt exhales therapist vibrates chest wall

78

Student Name: ________________________________________

SKILL: BREATHING EXERCISES


1

Attempt

2

Attempt

3




















Breathing Exercises Attempt

1

Attempt

2

Attempt

3

Diaphragmatic Breathing

Pt places dominant hand over midrectus abdominis area

Nondominant hand placed on midsternal area

Instruct pt to inhale slowly through the nose and watch dominant hand

through inspiration

Encourage pt to direct air so the dominant hand gradually rises

Instruct p to keep nondominant hand still

Apply firm counterpressure over pt's dominant hand just before instructing

them to inhale

As they inhale lessen your pressure

Practice exercise until pt no longer requires manual assistance

Progress pt by removing auditory

Pursed-lip Breathing

Position pt comfortably

Place your hand over midrectus abdominis area to detect activity during

expiration

Instruct pt to inhale slowly

Instruct pt to purse the lips before exhalation

Instruct pt to allow air to exhale through pursed lips without using

abdominal muscles

79

Instruct pt to stop exhaling when abdominal muscle activity is detected

o Segmental Breathing

o Relaxation Exercises

80

Student Name: _____________________________

SKILL: INTEGUMENTARY MANAGEMENT


1

Attempt

2

Attempt

3




















Integumentary Management Attempt

1

Attempt

2

Attempt

3

Interventions for edema management and to maintain integumentary integrity

Dressings

Identify different types

Apply and remove

Data collection for wounds

SKILL: COMPRESSION


1

Attempt

2

Attempt

3










81











COMPRESSION Attempt

1

Attempt

2

Attempt

3



For compression bandage:

Apply compression bandage starting distally and progressing proximally.

Slightly more pressure should be applied distally than proximally.

For compression pump:

Measure and record the patient’s blood pressure

Place a stockinette over the area to be treated and smooth out all wrinkles

and apply sleeve from unit

Determine inflation/deflation parameters based on patient blood pressure

and body part to be treated.

Operates and applies the selected device appropriately and safely.

Evaluates the patient’s response and adjusts treatment as necessary and

appropriate.


goals.

82

Aerobic Capacity and Endurance Lab

PTA Student Name: ___________________________ Patient: __________________________

RR __________ O2 Sat ___________ BP ______________ HR ___________________

Max HR = 220-age = ____________ 55-65% Max HR = _________________________

HRR = ([max HR – RHR] x goal percentage of HRR) + RHR = __________________________

Resting RPE __________________

Response to Aerobic Activity

Data Source Recumbent

Bicycle

Stair Climber Treadmill UE Ergometer

RR

HR

RPE

Time

Comments:

PTA Student Name: ___________________________ Patient: __________________________

RR __________ O2 Sat ___________ BP ______________ HR ___________________

Max HR = 220-age = ____________ 55-65% Max HR = _________________________

HRR = ([max HR – RHR] x goal percentage of HRR) + RHR = __________________________

Resting RPE ____________________

Response to Aerobic Activity

Data Source Recumbent

Bicycle

Stair Climber Treadmill UE Ergometer

RR

HR

RPE

Time

Comments:

83

Student Name: _________________________________

SKILL: PROSTHETICS


1

Attempt

2

Attempt

3




















PROSTHETICS Attempt

1

Attempt

2

Attempt

3

Skin Integrity

o Skin Check after doffing prosthesis

Edema Control

Soft Dressings

o Elastic bandage-figure 8-wrap

o Shrinker Socks

Semi-rigid Dressings

Unna dressing

Rigid Dressings

Donn/Doff/Care

Instruct a peer on techniques

Instruct a peer on Wearing Schedule/Prosthetic care

Balance/Therapeutic Exercises

Instruct a peer on Exercises

Pre-gait Activities/Gait Training

Instruct a peer on Exercises

Safety Awareness/Injury Prevention

Design a document to educate a patient

84

Student Name: ___________________________________________


PROFESSIONAL BEHAVIORAL SKILLS ASSESSMENT A Physical Therapist Assistant student is expected to exemplify professional behavior at all times. Student

behavior will be assessed in the middle of each semester. If students demonstrate unacceptable behavior, he/she

will be counseled on the behaviors and ways to make improvements, and will be reassessed. If a student

repeatedly fails to comply with the expected behaviors, dismissal from the program will be considered.

STUDENTS MUST DEMONSTRATE ACCEPTABLE BEHAVIOR IN ORDER TO

PARTICIPATE IN CLINICAL EDUCATION.

Expected Student Behavior Date Acceptable/

Unacceptable Comments

Demonstrates respect/consideration of

faculty/peers

Adheres to attendance policy

Accepts and gives constructive criticism

Communicates professionally verbally

and non-verbally with faculty, peers, and

others

Adheres to PTA dress code in lecture,

laboratory, and in clinical situations

Maintains Personal Hygiene

Adequate preparation and timely

submission of assignments

Actively participates in group

discussions and projects

Student Signature: ___________________________________ Date Reviewed: _______________________

Evaluator Signature: ___________________________________

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STUDENT SKILLS CHECKLIST BOOKLET - Johnson College · Demonstrating competency in skills included...

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